Multicultural Medicine and the Year 3/ 4 Student

"It is much more important to know what sort of patient has a disease
than what sort of disease a patient has." (Sir William Osler)

The U.S. is Becoming More Culturally Diverse

Our health care systems must adapt in order to provide care that is
culturally appropriate. When physicians and patients interact, their
respective cultural domains influence their assumptions and perceptions.
The quality of this cross-cultural interaction affects clinical decision-making
and outcomes (Flores, 1998). Health care providers must, therefore,
strive to view each patient as a unique individual, gathering culturally
relevant information in a trust-promoting manner in order to provide culturally
sensitive care.

How professional values may conflict with needs of patients of diverse
backgrounds.

Cultural competencies for physicians include being able to:

Discuss cultural issues openly and respond to culturally based cues.

Interpret the implications of symptoms as they are expressed by patients
from different cultures.

Work effectively with interpreters.

Consider learning new phrases and strategies to bridge communication gaps.

Develop the trust necessary for adherence to prescribed treatments and
recommendations.

A multicultural approach to healthcare delivery requires that the
patient-physician interaction go beyond focusing merely upon the chief complaint
to look at lifestyle, risk behaviors, stressors, and personal circumstances, as
well as the more visible cultural aspects of age, gender, race, and language.
This whole-patient perspective promotes more holistically focused care--
consistent with osteopathic philosophy.

Many medical schools are integrating knowledge of cultural diversity into
their curricula. Cases and readings assigned to students in both the CPC
and the PCC curricula are designed to help our students develop the knowledge,
skills, and attitudes to effectively meet the health care needs of an
increasingly diverse society. Efforts to promote and reinforce this
perspective in the clinical setting will enhance students' abilities to develop
a culturally sensitive approach to providing medical care.

Teaching Tips:

role model for the student those aspects of physician behavior consistent
with cultural knowledge and sensitivity.

Discuss openly with the student issues of diversity that present a
challenge to you.

Learn from students by giving them assignments (e.g. literature search,
web search) that will increase their knowledge of multicultural medicine and
then have them share the information with you.

Observe the student with patients of different cultures and provide
specific feedback.

Have the student spend some time just getting to know some of your
patients who come from different cultures.